Efficacy of Statin Therapy in Inducing Coronary Plaque Regression in Patients with Low Baseline Cholesterol Levels

• Published in: Journal of Atherosclerosis and Thrombosis 2016, Vol.23 (9), p.1055-1066
• Main Authors: Kohei Wakabayashi, Tsuyoshi Nozue, Shingo Yamamoto, Shinichi Tohyama, Kazuki Fukui, Shigeo Umezawa, Yuko Onishi, Tomoyuki Kunishima, Akira Sato, Shogo Miyake, Yoshihiro Morino, Takao Yamauchi, Toshiya Muramatsu, Kiyoshi Hibi, Mitsuyasu Terashima, Hiroshi Suzuki, Ichiro Michishita, on behalf of the TRUTH investigators
• Format: Article
• Language: Japanese
• ISSN: 1340-3478

[Aim] : The efficacy of statin therapy in inducing coronary plaque regression may depend on baseline cholesterol levels. We aimed to determine the efficacy of statin therapy in inducing coronary plaque regression in statin-naive patients with low cholesterol levels using serial intravascular ultrasound (IVUS) data from the treatment with statin on atheroma regression evaluated by virtual histology IVUS (TRUTH) study. [Methods] : The TRUTH study is a prospective, multicenter trial, comparing the efficacies of pitavastatin and pravastatin in coronary plaque regression in 164 patients. All patients were statin-naive and received statin therapy only after study enrollment. The primary endpoint was the observation of coronary plaque progression, despite statin therapy. [Results] : Serial IVUS data, at baseline and after an 8-month follow-up, were available for 119 patients. The patients were divided into three groups based on non-high-density lipoprotein cholesterol (HDL-C) levels-low : -170 mg/dl, n=39. Coronary plaque progression was noted in the low cholesterol group, whereas plaque regression was noted in the moderate and high cholesterol groups [%Δplaque volume : 2.3+-7.4 vs. -2.7+-10.7 vs. -3.2+-7.5, p=0.004 (analysis of variance)]. After adjusting for all variables, a low non-HDLC level (